A Technique To Measure Soft Tissue Changes Following NCCL Restorations

Non-carious cervical lesions (NCCLs) have a non bacterial origin, frequently occur at the cemento-enamel junction and are frequently restored and unrelated to dental caries. OBJECTIVE: To develop a non-invasive, highly reproducible technique to measure soft tissue changes and apply it to measure the gingival margin position changes after restoration of NCCL. METHODS: 41 patients with 3 composite resin NCCL restorations were included in the study. Gingival Index/GI and Plague Index/PI (Loe & Sillness), digital images and elastomeric impressions (Aquasil Ultra Heavy and XLV/Fast Set) were made during the 3 visits (restoration/A, baseline/B, 6month/C). Gingival phenotype was classified as thick or thin from the photographs. Casts (Fuji Rock type IV/GC) and a mold were made to standardize the cast position for imaging. Linear measurements were recorded (KeyenceVHX600 digital microscope). Follow up casts were also recorded using same molds as position guides. RESULTS: Intraclass correlation of 0.9963 was seen for the reproducibility of the technique. Generalized mixed model analysis of variance was used to evaluate the gingival margin position changes over time and by phenotype. Generalized estimating equations were used to examine GI and PI. No statistically significant difference in gingival height (p=0.6993), gingival height by phenotype (p=0.9102), and PI (p=0.3092) was noted at the three time intervals (A, B and C). A significant difference was seen in the mean length between the phenotypes (p=0.0211), with thick phenotype having shorter mean length than thin phenotype and in GI (p<0.0001) between GI/A and GI/B and between GI/A and GI/C. CONCLUSION: Within the limits of this study it can be concluded that gingival restoration placement and use of rubber dam retainers to retract NCCL would not change the gingival margin position by time and by phenotype. Composite-resin restoration did not have an effect on plaque accumulation.